MRS. DIANA SPOCK ADEBULEHIN (NPI# 1700965159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1700965159 |
Entity Type | Individual |
Full Name | MRS. DIANA SPOCK ADEBULEHIN |
Credential | P.A.-C. |
Practice Address |
1014 Sycamore Dr Ste. B Decatur GA 30030-1644 |
Mailing Address |
200 Ivy Glen Cir Avondale Estates GA 30002-1766 |
Practice Telephone | 4042991700 |
Practice Fax Number | 4042991616 |
Mailing Telephone | 4045505590 |
Mailing Fax Number | 4042991616 |
Enumeration Date | 2006-11-06 |
Last Update Date | 2007-07-09 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
004458 | GA | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
1014 SYCAMORE DR STE. B |
City | DECATUR |
State | GA |
Zip Code | 30030-1644 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770528895 | Valerie Lynne Compson | Specialist/Technologist | 1014 Sycamore Dr, Suite A, Decatur, GA 30030-1644 | 2006-06-20 |
1245863174 | Emory Physical Therapy, LLC | Physical Therapist | 1014 Sycamore Dr, Decatur, GA 30030-1644 | 2020-02-19 |
1104274323 | Monal, LLC | Physician Assistant | 1014 Sycamore Dr, Suite B, Decatur, GA 30030-1644 | 2016-05-27 |
1265849343 | Gary Anthony Rudolph Bowen | Physician Assistant | 1014 Sycamore Dr, Suite B, Decatur, GA 30030-1644 | 2014-07-21 |
1275760720 | Daniel Thomas Huttman | Orthopaedic Surgery | 1014 Sycamore Dr, Suite B, Decatur, GA 30030-1644 | 2009-06-11 |
1346474004 | Amanda Lauren Dempsey | Orthopaedic Surgery | 1014 Sycamore Dr, Suite B, Decatur, GA 30030-1644 | 2009-05-11 |
1043461650 | Alexandra Moran | Physical Therapist | 1014 Sycamore Dr, Suite A, Decatur, GA 30030-1644 | 2008-10-02 |
1790864049 | Timothy J. Mills | Registered Nurse | 1014 Sycamore Dr, Ste. B, Decatur, GA 30030-1644 | 2006-11-06 |
1720167083 | Jessica E. Simbro | Physical Therapist | 1014 Sycamore Dr, Ste. B, Decatur, GA 30030-1644 | 2006-11-06 |
1396824991 | Corey Darnell Bennett | Specialist/Technologist | 1014 Sycamore Dr, Ste. B, Decatur, GA 30030-1644 | 2006-11-03 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801413174 | Pa-c Surgical Assist, LLC | Clinic/Center | 520 W Ponce Leon Ave #1706, Decatur, GA 30030 | 2020-07-02 |
1417587478 | Elizabeth Heffron | Acupuncturist | 619b East College Avenue, Decatur, GA 30030 | 2020-01-17 |
1669016143 | Atlanta Upper Cervical Chiropractic LLC | Chiropractor | 125 E Trinity Place, Suite #247, Decatur, GA 30030 | 2019-10-29 |
1831757418 | Jessica Stewart | Counselor | 755 Commerce Dr Ste 903, Decatur, GA 30030 | 2019-05-30 |
1699238733 | Dinah Augustin | Registered Nurse | 1458 Church St., Unit B, Decatur, GA 30030 | 2019-04-06 |
1093284291 | Eliza Segell | Social Worker | 165 Dekalb Industrial Way Ste D-1, Decatur, GA 30030 | 2018-11-16 |
1912476466 | Positive Impact Health Centers, Inc. | Pharmacy | 523 Church Street, Suite B, Decatur, GA 30030 | 2018-11-14 |
1932685096 | T2 Imaging | Radiology | 1376 Church Street, Suite 100, Decatur, GA 30030 | 2018-07-12 |
1992292858 | Keeanna M Powell | Counselor | Agape Transformation Practice, 235 E. Ponce De Leon Ave Suite 103, Decatur, GA 30030 | 2018-04-17 |
1780185488 | Solutions Ae Inc | Counselor | One West Square Court, Suite 710, Decatur, GA 30030 | 2018-02-27 |
Find all providers in zip 30030 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891136750 | Rodney Oneal Morrison | Physician Assistant | 3204 Jefferson Square Ct, Decatur, GA 30030-1730 | 2013-07-08 |
1558625319 | Coraccess, Inc | Physician Assistant | 1478 Leafview Rd, Decatur, GA 30033-2112 | 2012-06-26 |
1326525437 | Aopa, LLC | Physician Assistant | 2801 N Decatur Rd Ste 200, Decatur, GA 30033-5936 | 2018-07-21 |
1104274323 | Monal, LLC | Physician Assistant | 1014 Sycamore Dr, Suite B, Decatur, GA 30030-1644 | 2016-05-27 |
1235505280 | Moniqua Turner | Physician Assistant | 2675 N Decatur Rd, Decatur, GA 30033-6131 | 2015-08-13 |
1982093480 | Southeastern Orthopedic Surgical Pa, LLC | Physician Assistant | 2801 N Decatur Rd, Suite 200, Decatur, GA 30033-5949 | 2015-01-21 |
1861768467 | Lindsay Contracting Services | Physician Assistant | 2801 N Decatur Rd Ste 200, Decatur, GA 30033-5936 | 2012-03-28 |
1740560978 | Midwestern Advanced Orthopaedics and Sports Medicine Inc | Physician Assistant | 2801 N Decatur Rd, Suite 200, Decatur, GA 30033-5949 | 2011-08-19 |
1114169703 | Edg Sports Medicine,inc | Physician Assistant | 2801 N Decatur Rd, Suite 200, Decatur, GA 30033-5949 | 2009-03-30 |
1114110061 | Douglas T. Johnson | Physician Assistant | 2801 N Decatur Rd Ste 200, Decatur, GA 30033-5936 | 2007-08-23 |
Find all providers in DECATUR |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.